![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Quintal on April 18, 2008, at 12:54:57
Anyone tried cyproheptadine for insomnia? My pdoc will only give me 14 days supply of zopiclone every month, and so far I haven't been able to manage without it. I'm really struggling because sleeplessness is a major trigger for hypomania (and even full-blown mania), and I find endlessly cycling on and off sleeping drugs makes me unstable - because I don't sleep well at all on the nights I go without zopiclone, or take a half-dose, and this affects my mood the next day. I'm looking into finding a non-benzo hypnotic to help me over the 14 days I have to go without zopiclone, and at the moment cyproheptadine is looking like a strong contender.
__________________________________________________
1: J Pharmacol Sci. 2007 Feb;103(2):201-6. Epub 2007 Feb 8. Links
Effects of some H1-antagonists on the sleep-wake cycle in sleep-disturbed rats.
Tokunaga S, Takeda Y, Shinomiya K, Hirase M, Kamei C.
Department of Medicinal Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Tsushima-naka 1-1-1, Okayama 700-8530, Japan.The present study was undertaken to investigate the effects of some H(1)-antagonists on the sleep-wake cycle in sleep-disturbed rats in comparison with those of nitrazepam. Electrodes were chronically implanted into the frontal cortex and the dorsal neck muscle of rats for the electroencephalogram (EEG) and electromyogram (EMG), respectively. EEG and EMG were recorded with an electroencephalograph. SleepSign ver. 2.0 was used for EEG and EMG analysis. The total times of waking, non-rapid eye movement (non-REM), and rapid eye movement (REM) sleep were measured from 10:00 to 16:00. Nitrazepam showed a significant decrease in sleep latency, total waking time, and delta activity and an increase in the total non-REM sleep time. A significant decrease in the sleep latency was observed with diphenhydramine, chlorpheniramine, and cyproheptadine. Cyproheptadine also caused a significant decrease in the total waking time and increases in total non-REM sleep time, REM sleep time, slow wave sleep, and delta activity, although no remarkable effects were observed with diphenhydramine and chlorpheniramine. In conclusion, cyproheptadine can be useful as a hypnotic, having not only sleep inducing-effects, but also sleep quantity- and quality-increasing effects.
PMID: 17287588 [PubMed - indexed for MEDLINE]
__________________________________________________According to this study, cyproheptadine increases both sleep quantity and quality, making it superior to benzos in this regard. It has a short half-life of 1-4 hours, so next-day grogginess shouldn't be a problem unlike with Seroquel et al - my pdoc's suggestion... I'm thinking of taking a copy of this study with me on Tuesday, and hopefully I can persuade him to give me a trial. I can't see any good reason to refuse, but he can be a bit of a pr*ck in that regard. On the plus side, it's so much cheaper than Seroquel or trazodone (I can't tolerate either of them anyway), and has fewer side effects (I hope). I've tried Benadryl (diphenhydramine) and chlorpheniramine many times. I find diphenhydramine too drying on the mucous membranes, and it tends to cause a bit of a next-day hangover. Chlorpheniramine is better - I'm taking it now on the days I go without zopiclone, but it's not very strong. Does anyone know the relative antimuscarinic effects of these three antihistamines? How drying is cyproheptadine?
Q
Posted by Sigismund on April 18, 2008, at 14:06:34
In reply to Periactin (cyproheptadine) as a hypnotic, posted by Quintal on April 18, 2008, at 12:54:57
Not unlike Remeron/Avanza for me.
Sleep is deepened, which is good.
I could never stand either once I was awake and had to function in a kind of sludge until well after lunch.
So I prefer to sleep badly than take either of them.
People do say though that you get used to that effect or it goes away in time, with Remeron anyway.
Posted by Quintal on April 18, 2008, at 14:36:27
In reply to Re: Periactin (cyproheptadine) as a hypnotic » Quintal, posted by Sigismund on April 18, 2008, at 14:06:34
I had the same problem with Remeron, so I hoped the short half-life of cyproheptadine would make it less likely to cause next-day grogginess. Remeron lasts for well over a day, while cypro alledgedly lasts for up to four hours, so I would have thought there would be some noticable difference. Is it as strong as Benadryl? How did you respond to that, or Piriton?
Q
Posted by Sigismund on April 18, 2008, at 14:56:45
In reply to Re: Periactin (cyproheptadine) as a hypnotic » Sigismund, posted by Quintal on April 18, 2008, at 14:36:27
Are you sure about this
> I hoped the short half-life of cyproheptadine would make it less likely to cause next-day grogginess. Remeron lasts for well over a day, while cypro alledgedly lasts for up to four hours
I had this idea that cypro had a long halflife too.
But it seems I'm wrong.
I dunno. Maybe I'm sensitive to the hangover?
Posted by Quintal on April 18, 2008, at 15:28:25
In reply to Re: Periactin (cyproheptadine) as a hypnotic » Quintal, posted by Sigismund on April 18, 2008, at 14:56:45
According to Wiki the half-life of cypro is 1-4 hours and the BNF recommends taking it 3-4 times a day for allergies, so I would think that suggests a short half-life. On PubMed I found it lasts up to 12 hours in cats, but only three in itchy dogs. There doesn't seem to be much information on the half-life of cypro in humans.
Q
Posted by dbc on April 18, 2008, at 16:42:27
In reply to Re: Periactin (cyproheptadine) as a hypnotic » Sigismund, posted by Quintal on April 18, 2008, at 15:28:25
Remeron knocked me out in a way that nothing else ever has. I wouldnt reccomend it as an AD though.
Posted by undopaminergic on April 18, 2008, at 22:22:52
In reply to Periactin (cyproheptadine) as a hypnotic, posted by Quintal on April 18, 2008, at 12:54:57
It's not very drying in my experience, and it does last longer than 4 hours for me. I don't take it if I have to get up early.
Note, however, that the shortest-lasting benzodiazepine midazolam (Dormicum) usually lasts long enough for me. I suppose Ï'm just not prone to waking after having fallen asleep.
Isn't it OTC, by the way?
Posted by Quintal on April 19, 2008, at 7:46:40
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by undopaminergic on April 18, 2008, at 22:22:52
>Isn't it OTC, by the way?
Yes in some countries, but not in the UK, so I'll have to get a prescription.
Q
Posted by kaleidoscope on April 20, 2008, at 12:31:32
In reply to Periactin (cyproheptadine) as a hypnotic, posted by Quintal on April 18, 2008, at 12:54:57
Quintal,
Periactin is OTC in the UK but very few pharmacies will have it in stock and it will never be on display in the shop. They will be able to order it for you though. I bought some once.
Posted by kaleidoscope on April 20, 2008, at 12:34:23
In reply to Re: Periactin (cyproheptadine) as a hypnotic » Quintal, posted by kaleidoscope on April 20, 2008, at 12:31:32
PS. Tell them it's for an itch rash on (somewhere they can't ask to see)........ it's not approved for insomnia so they might not order it for you if they know you will will taking it for an unapproved indication.
Periactin has been OTC in the UK for a very long time but they may not be aware of this because it is so rarely used here.
Posted by Quintal on April 20, 2008, at 12:57:19
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by kaleidoscope on April 20, 2008, at 12:34:23
Thank you Ed, I thought I read somewhere that it was P*M in the UK but I've just looked in the BNF and it doesn't seem to be restricted - I hadn't noticed that before. I've never heard of anyone using it here either. I might just tell them it's for hayfever and that other remedies haven't worked that well, and also that it might help me sleep at night. I'd worry they'll just try to palm me off with Piriton or something else they have in the shop if I say it's for a rash.
I don't think I'll bother bringing it up with pdoc if I can get it on my own. As you know, time is limited and I don't want him to get distracted. What was it like?
Q
Posted by Quintal on April 20, 2008, at 12:59:01
In reply to Re: Periactin (cyproheptadine) as a hypnotic » kaleidoscope, posted by Quintal on April 20, 2008, at 12:57:19
Why does P*M come out with a star in it?
Posted by kaleidoscope on April 20, 2008, at 13:13:44
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by Quintal on April 20, 2008, at 12:59:01
Hi Q
No idea why P.O.M has a star. Periactin is a P-medicine in the UK, which means it's only available for sale from behind the counter in a pharmacy or from out of the dispensary. All P-meds have a capital P in a square box on the packaging.
Periactin seemed similar to Piriton for me, but caused more drowsiness. It felt stronger.
Posted by Quintal on April 21, 2008, at 8:56:37
In reply to Re: Periactin (cyproheptadine) as a hypnotic » Quintal, posted by kaleidoscope on April 20, 2008, at 13:13:44
I just ordered some. They don't have it in stock obviously, so I have to go back on Wednesday. I have to fill a form in too. How much did it cost?
Q
Posted by Quintal on April 24, 2008, at 17:11:10
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by Quintal on April 21, 2008, at 8:56:37
I finally got it yesterday - cost £1.55. I took some last night and it did seem to help me sleep better. It didn't seem as powerful as I'd thought though. I may have to take two if I'm using it on a regular basis. Tomorrow will be the acid test because I run out of zopiclone.
Q
Posted by sam34243 on February 22, 2009, at 19:17:35
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by Quintal on April 24, 2008, at 17:11:10
> I finally got it yesterday - cost £1.55. I took some last night and it did seem to help me sleep better. It didn't seem as powerful as I'd thought though. I may have to take two if I'm using it on a regular basis. Tomorrow will be the acid test because I run out of zopiclone.
>
> QI happened upon this thread when I was researching Cyproheptadine for my insomnia. How has it worked for you?
Posted by zzzz7 on April 5, 2009, at 7:33:55
In reply to Re: Periactin (cyproheptadine) as a hypnotic » undopaminergic, posted by Quintal on April 19, 2008, at 7:46:40
Is this drug available in Canada? I haven't seen it on the shelves. Am I just not looking carefully enough?
Anyone able to compare it to Sandomigran ?
Posted by myco on April 5, 2009, at 13:55:42
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by zzzz7 on April 5, 2009, at 7:33:55
Hey,
Yes it is available in canada. There are actually many of these old antihistamines still here but not in "general circulation"...meaning you will be lucky to find them on the self at most pharmacies in the country. The sales are so small that the companies who produce them produce them "in batches" then allow them to "sell out" before making more.
For:
Cyproheptadine (periactin is an old abandoned name - don't use it as it will only confuse pharmacists - will tell you long gone)
* this med is available from a small company called "Pharmascience Inc", based out of Quebec. It's OTC but you will need to either order it via that company itself or find a pharmacy who has it on their "order list"...they use specific "distributers" for meds...so usually if its not on their list..they cant get it. but you will find cool pharmacists who will go out of their way to help you and order it...."pull strings", in a way.
* so for the cyproheptadine go here:
Link:
http://www.pendopharm.com/ProductDetails.aspx?Part_Code=5760677132&Section=byalphaAlso:
-----That same company, Pharmscience Inc, puts out another old very useful antihistamine called
"Promethazine" (brand name Histantil; old name no longer used is "Phenergan").Not sure your use for cyproheptadine but if its for antihistamine properties than promethazine is also worth a look. but again not easy to find - order from company itself OTC.
myco
-----------------------------> Is this drug available in Canada? I haven't seen it on the shelves. Am I just not looking carefully enough?
>
> Anyone able to compare it to Sandomigran ?
Posted by omega on January 28, 2010, at 16:44:57
In reply to Re: Periactin (cyproheptadine) as a hypnotic » zzzz7, posted by myco on April 5, 2009, at 13:55:42
There must be an error with the 4 hours half-life thing regarding cyproheptadine. I have personally taken it many times, and when I am taking it I don't expect a very productive next day...either the half-life is incorrect or I'm very sensitive to it, anyhows, 4 mg taken before bedtimes will cause effects that I still feel until at least 4 or 5 pm the next day... 16 hours would be more like it instead of 4. As regarding it's strength , it is pretty effcicient... very much like mirtazapine to me. Hope it helps
Posted by Deneb on January 29, 2010, at 22:07:10
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by omega on January 28, 2010, at 16:44:57
Hello Omega!
Welcome to Psycho-Babble! I think I've read somewhere that people can vary in how fast they process a med, so maybe you just process it very slowly compared to other people. I don't know the half life myself though, so maybe it's not even right.
Deneb
Posted by sam34243 on January 29, 2010, at 22:12:46
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by omega on January 28, 2010, at 16:44:57
> There must be an error with the 4 hours half-life thing regarding cyproheptadine. I have personally taken it many times, and when I am taking it I don't expect a very productive next day...either the half-life is incorrect or I'm very sensitive to it, anyhows, 4 mg taken before bedtimes will cause effects that I still feel until at least 4 or 5 pm the next day... 16 hours would be more like it instead of 4. As regarding it's strength , it is pretty effcicient... very much like mirtazapine to me. Hope it helps
I experienced the same thing. I would take ~4 mg in a syrup right before bed, and the next day I would be totally out of it and really sleepy, into the afternoon. I eventually had to stop using it.
Posted by Brainbeard on February 6, 2010, at 7:47:33
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by omega on January 28, 2010, at 16:44:57
> There must be an error with the 4 hours half-life thing regarding cyproheptadine. I have personally taken it many times, and when I am taking it I don't expect a very productive next day...either the half-life is incorrect or I'm very sensitive to it (.....)
This has to do with a misunderstanding about half-lifes. The half-life of a drug only refers to the blood levels of that drug in your body. It doesn't say anything about the duration of the drug's effects on your brain.
For instance, Geodon's half-life is about 8 hours, but the half-life of its 5HT2a-antagonism (one if its effects on the brain) is close to 24 hours.
The effects of a drug on your brain can last much longer than the time the drug stays in your blood. Such will probably be the case with cyproheptadine.
Alternatively, you might of course be a slow metabolizer.
Posted by Mikez on February 7, 2010, at 10:07:15
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by Brainbeard on February 6, 2010, at 7:47:33
can periactin cause depression? I know its a blanket statement, but that aside, is there an established link to depression? I have a stash and it is ridiculously cheap. The few days Ive taken periactin it helped my sleep. But I dont want to potentially be taking something that could conteract an antidepressant im on. At the moment im on Remeron for sleep, but other than the noradrenaline receptor effects, how would periactin really differ from Remeron, which is marketed as an antidepressant
Posted by omega on February 8, 2010, at 15:19:20
In reply to Re: Periactin (cyproheptadine) as a hypnotic » omega, posted by Deneb on January 29, 2010, at 22:07:10
> Hello Omega!
>
> Welcome to Psycho-Babble! I think I've read somewhere that people can vary in how fast they process a med, so maybe you just process it very slowly compared to other people. I don't know the half life myself though, so maybe it's not even right.
>
> DenebThank you Deneb :)
Well, it seems I had a wrong/incomplete understanding of what half-life means confusing it with the effects the substance has on the brain
Posted by Tony P on September 8, 2011, at 20:57:25
In reply to Re: Periactin (cyproheptadine) as a hypnotic, posted by Brainbeard on February 6, 2010, at 7:47:33
Excellent point! I've been confused about half-lives for years, and I'm an ex-biochemist ;-)
I suppose an extreme example would be the "irreversible" MAOI's, which may clear the bloodstream in hours, but continue to be latched on their site until you make fresh MAO.
My experience with cyproheptadine is the same as others, i.e. too long-lasting for regular use. But it's more natural-feeling than Benadryl (DPH) IMHO. And it *does* seem to help with SSRi sexual dysfunction -- bonus!!
Tony P
> > There must be an error with the 4 hours half-life thing regarding cyproheptadine. I have personally taken it many times, and when I am taking it I don't expect a very productive next day...either the half-life is incorrect or I'm very sensitive to it (.....)
>
> This has to do with a misunderstanding about half-lifes. The half-life of a drug only refers to the blood levels of that drug in your body. It doesn't say anything about the duration of the drug's effects on your brain.
>
> For instance, Geodon's half-life is about 8 hours, but the half-life of its 5HT2a-antagonism (one if its effects on the brain) is close to 24 hours.
>
> The effects of a drug on your brain can last much longer than the time the drug stays in your blood. Such will probably be the case with cyproheptadine.
>
> Alternatively, you might of course be a slow metabolizer.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.